Wurglitz, Glen M
Wurglitz, Glen M is an sole proprietor health care provider with primary practice located at 14780 W Mountain View Blvd Ste 210 , Surprise AZ 85374-7281. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Wurglitz, Glen M can be contacted via phone (630) 360-7309.Contact Information
Primary practice address
14780 W Mountain View Blvd Ste 210
Surprise AZ 85374-7281
Phone: (630) 360-7309
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | ||
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 20041231A | Indiana |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 071005590 | Illinois |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6301015915 | Michigan |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY005163 | Arizona |
Profile Details
| NPI number | 1932144615 |
|---|---|
| LBN Legal business name | Wurglitz, Glen M |
| Credentials | PYSD, HSPP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 18th, 2006 |
| Last updated | Feb 20th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932144615 | NPPES |
| Indiana | MEDICAID | 200918700 |
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